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Remote Prior Authorization Jobs in Virginia (NOW HIRING)

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

... Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client ...

Financial Educator Remote

Annandale, VA · On-site +1

$23 - $27/hr

Opportunity Overview We have an immediate opening for an Financial Educator Remote to join our team ... Perform aspects of benefit verification and prior authorization * Provide ongoing financial ...

Financial Educator Remote

Annandale, VA · On-site +1

$23 - $27/hr

Opportunity Overview We have an immediate opening for an Financial Educator Remote to join our team ... Perform aspects of benefit verification and prior authorization * Provide ongoing financial ...

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Remote Prior Authorization information

See Virginia salary details

$13

$20

$31

How much do remote prior authorization jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for remote prior authorization in Virginia is $20.71, according to ZipRecruiter salary data. Most workers in this role earn between $17.16 and $22.88 per hour, depending on experience, location, and employer.

What is a remote prior authorization job?

Remote prior authorization jobs involve reviewing and processing requests from healthcare providers to determine if specific medical treatments, medications, or procedures are covered by a patient's insurance plan. Employees in these roles work from home, utilizing online systems to evaluate clinical information, communicate with providers, and ensure compliance with insurance policies. This position requires a strong understanding of medical terminology, insurance guidelines, and attention to detail to facilitate timely and accurate approvals or denials. Remote prior authorization specialists help streamline patient care by acting as a liaison between healthcare providers and insurance companies.

What are some common challenges faced by remote prior authorization specialists, and how can they be addressed?

Remote Prior Authorization specialists often encounter challenges such as navigating complex insurance requirements, managing high volumes of requests, and maintaining clear communication with healthcare providers and payers. Staying organized and up-to-date on payer policies is crucial, as requirements can vary widely between insurers. Utilizing workflow management tools and fostering strong collaboration with clinical and administrative teams can help streamline processes and reduce delays, ultimately ensuring patients receive timely care.

What are the key skills and qualifications needed to thrive as a remote prior authorization specialist, and why are they important?

To thrive as a Remote Prior Authorization Specialist, you need a solid understanding of medical terminology, insurance processes, and healthcare regulations, often supported by experience in medical billing or coding. Familiarity with electronic health record (EHR) systems, insurance portals, and prior authorization software is typically required. Attention to detail, strong organizational skills, and effective communication are crucial soft skills in this role. These skills ensure timely and accurate processing of authorizations, reducing claim denials and supporting efficient patient care.

What is the difference between Remote Prior Authorization vs Remote Medical Coder?

AspectRemote Prior AuthorizationRemote Medical Coder
Required CredentialsMedical credentials, insurance knowledgeMedical coding certification (CPC, CCS)
Work EnvironmentHealthcare offices, insurance companies, remoteHealthcare facilities, remote coding jobs
Industry UsageInsurance, healthcare providersHospitals, clinics, billing companies
Job FocusReviewing and approving insurance requestsTranslating medical records into codes

Remote Prior Authorization and Remote Medical Coder roles both operate within the healthcare industry but focus on different tasks. Remote Prior Authorization involves reviewing insurance requests for coverage approval, requiring insurance and medical knowledge. Remote Medical Coders translate medical records into standardized codes, primarily focusing on billing and documentation. Both roles can be performed remotely and require healthcare-related credentials, but their daily responsibilities and skill sets differ significantly.

What is a remote prior authorization job?

Remote prior authorization jobs focus on working with insurance companies to coordinate benefit coverage and get approval to provide care for a patient. In this pre-authorization role, you may collect documentation and proof of insurance, perform data entry, help evaluate the need for a particular process, and otherwise work from home to help manage the prior authorization process. Remote prior authorization personnel often answer telephone calls to provide consultations, perform initial benefit verification, document case status, actions, and outcomes in a database, and use customer service skills to help expedite cases as needed. Since this is a remote call center-style job, you may be asked to arrange for a quiet office in your house that is free of distractions.

What are the most commonly searched types of Prior Authorization jobs in Virginia? The most popular types of Prior Authorization jobs in Virginia are:
What are popular job titles related to Remote Prior Authorization jobs in Virginia? For Remote Prior Authorization jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Remote Prior Authorization jobs in Virginia look for? The top searched job categories for Remote Prior Authorization jobs in Virginia are:
What cities in Virginia are hiring for Remote Prior Authorization jobs? Cities in Virginia with the most Remote Prior Authorization job openings:
Infographic showing various Remote Prior Authorization job openings in Virginia as of August 2026, with employment types broken down into 76% Full Time, 21% Part Time, and 3% Contract. Highlights an 100% Remote job distribution, with an average salary of $43,087 per year, or $20.7 per hour.

Reimbursement Specialist - Days - Remote

VCU Health

Richmond, VA • On-site, Remote

$19 - $26.25/hr

Full-time

Re-posted 28 days ago


VCU Health rating

7.3

Company rating: 7.3 out of 10

Based on 171 frontline employees who took The Breakroom Quiz

305th of 887 rated healthcare providers


Job description

***Must have BOTH a current VA Pharmacy and PTCB License***
The Reimbursement Specialist improves revenue collection pertaining to high cost medications that require prior authorization. This job will initiate, follow-up, and proceed with approval and/or denials of prior authorizations efficiently via phone, fax, or electronically.
The Reimbursement Specialist carries out benefit investigation and coordinates Patient Assistance Programs and/or copay cards for patients with high co-pays or those without insurance coverage. This role works closely with nursing and physicians in order to obtain required documentation for prior authorization and billing.
The Reimbursement Specialist arranges refills, transfers, and delivery of medications. Updates patient case management system regularly. Ideally, this role is familiar with disease state terminology or willingness to research. This role also works as a Pharmacy Technician when deemed necessary.
Licensure, Certification, or Registration Requirements for Hire:
Current certification by the Pharmacy Technician Certification Board (PTCB)
Current licensure with the Virginia State Board of Pharmacy
By virtue of societal trust and security explicitly imparted to pharmacies for the control of drugs, candidate/incumbent must have a clean criminal record (i.e. no felony conviction; no drug or pharmacy related convictions, including misdemeanors); no denial, suspension, revocation, or restriction of registration or licensure by any State Board of Pharmacy
Licensure, Certification, or Registration Requirements for continued employment:
Current certification by the Pharmacy Technician Certification Board (PTCB)
Current licensure with the Virginia State Board of Pharmacy
Experience REQUIRED:
Minimum of one (1) year of previous pharmacy practice experience in a similar setting
Minimum of three (3) years of prior experience with Manufacturers Patient Assistance Programs and prior experience with prescription on-line adjudication
Previous work experience using a personal computer and various billing software applications as well as e-mail, spreadsheets, word processing, databases, etc.
Experience PREFERRED: N/A
Education/training REQUIRED:
High School Diploma or equivalent
Education/training PREFERRED:
Associate's Degree in Business or related field from an accredited program
Independent action(s) required:
Identifies equipment problems; various aspects of assisting the pharmacist that don't require a pharmacist's supervision or check.
Supervisory responsibilities (if applicable): N/A
Additional position requirements:
Able to work all shifts, weekends, holidays, emergency coverage
Age Specific groups served: N/A
Physical Requirements (includes use of assistance devices as appropriate):
Physical: Lifting less than 20 lbs.
Activities: Prolonged standing, Prolonged sitting, Frequent bending, Walking (distance), Climbing (steps, ladder, other), Reaching (overhead, extensive, repetitive), Repetitive motion
Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking
Emotional: Fast pace environment, Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Noisy environment, Able to adapt to frequent change
EEO Employer/Disabled/Protected Veteran

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